A lot of attention has been paid to postpartum depression, due in part to celebrities such as Brooke Shields, Marie Osmond, and Gwyneth Paltrow helping to destigmatize the most common complication of childbirth. As an advocate, therapist, mother, and survivor of postpartum depression, I am happy that medical communities and the public at large are becoming familiar with perinatal mood/anxiety disorders (PMADs, the clinical term). However, there is still much work to be done.
Most women of childbearing age are not aware of the potential to develop depression or anxiety during pregnancy. A myth exists that pregnancy is a period that is protective of emotional health. Media images portraying pregnant women blissfully anticipating birth with swollen bellies may further trouble women who feel down or anxious while pregnant and may further compound a sense of helplessness or a drop in willingness to reach out for help.
The reality is that for some 10% of pregnant women, antenatal/prenatal depression presents as a challenge. And 6% of pregnant women will experience anxiety. The percentages are likely higher and underreported. Most at risk are pregnant teens and those in poverty, where the rates of mood challenges surrounding childbirth are considerably higher.
The good news is that depression and anxiety during pregnancy are very treatable, as is postpartum depression. What’s key is making sure women are getting the proper screening at several points during their pregnancy and throughout the first year after giving birth. Women’s hormonal fluctuations, sleep deprivation, and any prior or family history of depression or anxiety are all risk factors for women to develop this very treatable mental health challenge.
Mothers-to-be who are feeling down or anxious should reach out for help and contact Postpartum Support International at www.postpartum.net. Volunteers from around the world and in every state in the U.S. can connect women and their families to therapists, psychiatrists, doulas, lactation consultants, and support groups. Women also can receive comfort and resources by reading Postpartum Progress at www.postpartumprogress.com. Some of the most helpful books I have recommended to my own clients in relation to depression and anxiety during pregnancy are the following:
Pregnancy Blues: What Every Woman Needs to Know About Depression During Pregnancy, by Shaila Misri, MD (2006)
Pregnant on Prozac: The Essential Guide to Making the Best Decision for You and Your Baby, by Shoshana Bennett, PhD (2008)
Beyond the Blues: Prenatal and Postpartum Depression: A Treatment Manual, by Shoshana Bennett and Pec Indman (2011 edition)
The Pregnancy and Postpartum Anxiety Workbook: Practical Skills to Help You Overcome Anxiety, Panic Attacks, Obsessions, and Compulsions, by Pamela Wiegartz (2009)
The good news is that such challenges are treatable, and a woman can expect to recover with swift treatment and minimal disruption to her well-being and that of her family, but prompt treatment (psychotherapy, social supports, self-care plan, and in some cases, medication management) is vital. Negative outcomes should a woman not seek treatment include pregnancy complications (constriction of blood flow to fetus can occur, as well as premature delivery) and a continuous episode of anxiety/depression that spans out past pregnancy into the critical first year of the baby’s life; complications are deleterious without intervention and can impact maternal-child bonding as well as impair child development. Therefore, screening at regular intervals (each trimester and throughout the first year postpartum) are key in preventing/treating perinatal challenges. Should a woman feel like she is experiencing anxiety or depression, she needs to know it’s not her fault and her complication can be remedied with prompt interventions by skilled, trained perinatal practitioners. Relief will occur with proper treatment, and women can move on to enjoy and embrace the miracle of mothering.
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